A new study funded by Australian Rotary Health (ARH) suggests a rise in the number of older Australians participating in screening methods for bowel cancer.

Natalie Dodd from the University of Newcastle was awarded the Rotary District 9650 Bowelscan PhD Scholarship by ARH in 2015 to look at ways of improving uptake of colorectal screening among primary care attendees.

From previous data collected in 2010-2011, screening rates for Bowel Cancer were quite low, with only around 37% of targeted individuals taking up screening offered by National Bowel Cancer Screening Australia (NBCSA).

“For most people, a faecal occult blood test (FOBT) every two years is the most appropriate way to detect colorectal cancer. Australians 50 years and over receive a FOBT every two years from the National Bowel Cancer Screening Program,” Natalie said.

“Our study surveyed people in general practice and outpatient clinics and found higher levels of people participating in screening for colorectal cancer.”

From this study it was found that around 49% of people who were sent the FOBT, reported returning a completed kit in the past 2 years, with 25% sourcing it from their General Practitioner (GP).

“Although since these higher participation rates were taken from a small sample, the results can’t be generalised to the NBCSA data,” Natalie said.

Natalie believes GPs play a vital role in encouraging people to complete colorectal cancer screening and says their role could be enhanced to support the National Bowel Cancer Screening program.

“The most interesting aspect of this research was the interest and enthusiasm that general practitioners had to provide the best preventive care for their patients. All the general practitioners involved in our studies were grateful they could provide an enhanced experience for their patients.”

Those that were eligible for the study received either usual care from their GP or received an intervention. The intervention consisted of information about screening, a FOBT and encouragement from their GP to complete the test.

“Those that received the intervention were seven times more likely to complete CRC screening than those receiving usual care,” Natalie said.

In addition to this, the study revealed that some participants screening for colorectal cancer were using more intensive methods than necessary, such as colonoscopy.

“Thirty-seven per cent of participants reported colonoscopy in the past five years, a higher rate than that reported in previous research.”

“Our results suggest that there may be over-screening via colonoscopy among general practice patients. Strategies to support GPs to identify and manage those screening outside of guidelines may lead to decreases in unnecessary colonoscopy.”

Natalie said this project is the first step in developing an intervention which aims to improve CRC screening among average risk persons aged 50-75 and strongly aligns with Rotary Australia’s emphasis on bowel cancer screening and community health.

“The results from our studies were novel within Australia. Previous research has attempted to quantify the magnitude of under-screening for colorectal cancer, however the way this was assessed differed from clinical practice guidelines for colorectal cancer screening. Our studies collected up-to-date data that assessed the magnitude of under-screening in line with current screening recommendations.”

Natalie recently submitted her PhD thesis and has had 6 journal articles from this research published in a number of peer-reviewed journals.

Journal articles:

1. Testing the effectiveness of a general practice intervention to improve uptake of colorectal cancer screening: a randomised controlled trial. 
2. Have we increased our efforts to identify strategies which encourage colorectal cancer screening in primary care patients? A review of the volume and quality of intervention studies over time.
3. Prevalence of appropriate colorectal cancer screening and preferences for receiving colorectal cancer screening advice among people attending outpatient clinics.
4. What do Australian general practice patients know about colorectal cancer risk factors and screening recommendations?
5. Are Australian general practice patients appropriately screened for colorectal cancer? A cross-sectional study. 
6. Testing the effectiveness of a primary care intervention to improve uptake of colorectal cancer screening: A randomised controlled trial protocol. 

Media contact: Jessica Cooper – (02) 8837 1900 or jessica@arh.org.au